Vancomycin intoxication in a patient with inappropriate antidiuretic hormone syndrome and diarrhea

Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L) to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of res...

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Bibliographic Details
Main Authors: Patricia Hidalgo-Collazos, Cristina López González-Cobos, Paula Arrabal-Durán, María Sanjurjo-Sáez
Format: Article
Language:English
Published: Grupo Aula Médica 2015-07-01
Series:Farmacia Hospitalaria
Subjects:
Online Access:http://www.aulamedica.es/fh/pdf/8095.pdf
Description
Summary:Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L) to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h) is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic
ISSN:1130-6343
2171-8695